|
|
|
|
|
Pulmonary Rehabilitation (PR) Services
|
|
|
Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months
|
|
|
Appeals Revisions AIC Requirements
|
|
|
|
|
|
Date Issued:
|
02-05-2010
|
|
Implementation Date:
|
07-06-2010
|
|
Effective Date:
|
07-01-2010
|
|
Source:
|
CMS - Transmittal
|
|
Source#:
|
CR6736
|
|
Category:
|
Edits Drugs
|
|
CBSI Contact:
|
Missy Tieken
|
|
|
|
Medicare contractors and shared systems must utilize CAS segment CARCs when processing MSP claims. Medicare contractors and shared systems must take into consideration the proper claim rules, as found in Pub. 10005/Chapter 5/ 40.7.5 entitled Effect of Failure to File Proper Claim, when processing MSP claims. The CARCs found in BR 6426.6 and 6427.6 identify potential situations when claims are not properly filed with the primary payer. BR 6426.6 currently reads: ?The shared systems shall add the following claim CARC amounts to the primary payer payment amount if one of the listed CARCs is submitted on a claim: 15, 17, 29, 58, 61, 95, 112, 117, 125, 130, 150, 163, 164, 179, 181, 182, 197, 210, 223, B4, B5, B7, B8, B10, B16.? BR 6427.6 states: The shared systems shall add the following claim CARC amounts to the primary payer payment amount for that service as found in the 2430 SVD02 (or the 2320/AMT02 when 2320/SBR01 = P and 2320/AMT01 = D), if one of the listed CARCs is submitted in the 2320 loop or the claim is submitted at the claim level) and send this amount as the paid amount to MSPPAY: 15, 17, 29, 58, 61, 95, 112, 117, 125, 130, 150, 163, 164, 179, 181, 182, 197, 210, 223, B4, B5, B7, B8, B10, B16.
|
http://www.cms.gov/transmittals/downloads/R73MSP.pdf
|
<< Return to News
|
|
